MYLES JORDAN HASTINGS Dentist License verification

Business Entity

ACTIVE

License Type

Dentist

Description

LICENSED DENTIST CONTROLLED SUBSTANCE

License Number

31*****71

License Status

ACTIVE

Business

First Name

MYLES

Middle

JORDAN

Last Name

HASTINGS

Business Name

MYLES JORDAN HASTINGS

Original Issue Date

08/13/2018

Effective Date

05/28/2024

Expiration Date

09/30/2027

City

MATTOON

State

Zip

61938

County

COLES

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

05/28/2024